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Abstract
The scales of some scalp disorders were
examined by scanning electron microscope (SEM), and transmission
electron microscope (TEM) with the purpose of revealing importance of
stratum cornuem in the diagnosis of these disorders and studying possible
correlation between morphological data and pathologic hypotheses in the
dermatoses of the scalp.
Patients and methods: 20 patients with various scaly scalp disorders are selected. From each patient, a skin surface biopsy for (SEM), and a punch skin biopsy for (TEM) were taken. They
included 6 patients with psoriasis, 5 patients with seborrheic dermatitis
(SD), 2 patients with dandruff, 2 patients with pityriasis amiantacea (PA), 2 patients with pityriasis rubra pilaris (PRP) and 2 patients with scaly
tinea capitis. Results: SEM revealed specific surface patterns (print) of
diseased cells which were: ”hexagonal” in psoriasis, ”heart-shaped” in
SD, ”polyhedral” in dandruff and PA, ”rock-like” in PRP and fungal
colonies obscuring the external morphological features in scaly tinea
capitis. TEM revealed presence of remnants of nuclei and lipid droplets in
all scaly scalp dermatoses. The characteristic findings for each disorder were: in psoriasis ”retained intacellular lamellar bodies”, in SD &
dandruff ”numerous lipid inclusions, intercellular lipids and wide
intercellular space ”, in PA ”wide corneal separation with finger-like
projections”, in PRP ”almost normal intercellular space” and in scaly
tinea capitis ”normal stratum corneum structure with massive fungal
spores infiltration”. Conclusion: Specific SEM and TEM findings for
each scaly scalp disorder reflect the importance of the alteration of
stratum corneum in hypotheses of these diseases and that there is a different underlying pathologic process of every disease.